Re: tarlov cyst

Posted By ccf neuro M.D. on April 21, 1997 at 17:59:21:

In Reply to: tarlov cyst posted by Jan on April 11, 1997 at 18:02:07:







: would like information on freq. of symptoms re: tarlov
cyst.  How large they can become and what could cause the cyst to grow.  Suggested treatment



          


Perineurial, or Tarlov cysts, most often occur in the sacrum, a large bone at the bottom of the spine that connects the last lumbar vertebrae (L5) to the tailbone or coccyx. These can also occur in the lumbar spine. They may grow to about 2cm or so in extreme cases, and cause symptoms by pressing on the spinal nerve root they form off of, and/or by actually encasing fibers within the nerve in their walls. About 5% of people experiencing low back pain and sciatica, a pain that shoots down the back of the leg, will have such cysts on MRI scans if their spine--- but, in only about 1 in 5 of these 5% of all cases, or 1% overall, will the cysts have anything to do with being the actual CAUSE of the symptoms. Treatments include inserting a needle under Xray or CT scan guidance, which results in temporary decompression of the cyst and usually temporary alleviation of any symptoms associated with it. Definitive treatment is surgical, but, since fibers from the nerve root that the cyst forms off of are often encased
within the cyst wall, this may necessitate sacrifice of the affected nerve root, resulting in permanent numbness, weakness, or both in the muscles and skin the nerve supplies, in essence creating a permanent version of the symptoms that led to removal of the cyst. Alternatively, sometimes the cysts may be shunted by placing a tube in them that drains out the fluid. Migration of or infection of the shunt tube are risks of this treatment.